Performances of Depression Detection through Deep Learning-based Natural Language Processing to Mandarin Chinese Medical Records: Comparison between Civilian and Military Populations

Performances of Depression Detection through Deep Learning-based Natural Language Processing to Mandarin Chinese Medical Records: Comparison between Civilian and Military Populations

Objective: A certain portion of patients with depression is under-diagnosed and has attracted the attention in the field of natural language processing (NLP). In this study, we intended to explore the feasibility of transferring unstructured textual records into a screening tool to early detect depression. Methods: We recruited 22,355 medical records in Mandarin traditional Chinese from the psychiatry emergency department of a military psychiatry center from 2004 to 2019. We preprocessed all the context of present illness histories as corpus and the presence of clinical diagnoses of depression as an outcome. A state-of-the-art NLP model was developed based on a pretrained bidirectional encoder representation from transformers (BERT) model along with several convolutional neural network (CNN) and trained by the training set (80% of original data) of total samples (BERT_(general)) and of civilian samples (BERT_(civilian)) and of military samples (BERT_(military)) independently. The receiver operating characteristic (ROC) and area under curve (AUC) of three trained models were compared for predicting depression for the test dataset (20% of original data) of general and specific samples. Results: The experimental results demonstrated excellent performance of BERT_(general) for general samples (AUC = 0.93, sensitivity = 0.817, specificity = 0.920 for optimal cut-off point) and civilian sample (AUC = 0.91, sensitivity = 0.851, specificity = 0.851 for optimal cut-off point). BERT_(general) showed a significant underperformance of for military samples (AUC = 0.79, sensitivity = 0.712, specificity = 0.732, p ＜ 0.05 for optimal cut-off point). That of BERT_(military) was slight higher (AUC = 0.82, sensitivity = 0.708, specificity = 0.786 for optimal cut-off point) for military samples. Conclusion: This study showed the feasibility of applying deep learning technique as a depression-detection assistant tool in Mandarin Chinese medical records. However, the subjects' specific situation, e.g., military status, is warranted for further investigation.